What to do if you're a bystander at an accident
The Easter holiday period marks a busy time on the roads - and with it, an increase in roadside accidents. An emergency doctor shares what you can do to help if you witness one.
Gary Payinda is no stranger to accidents.
As an emergency doctor, he has spent the last 24 years dealing with everything from sprained ankles to cardiac arrests. He's worked in Northland emergency departments and even on a rescue helicopter. And in November, while driving home between Auckland and Whāngarei, he very unexpectedly became a bystander himself.
"I drove up on a very fresh head-on collision at highway speeds. It took me a minute to realise what had happened and to begin to act, even though I work with emergencies every day.
Emergency doctor Gary Payinda shares some tips for what to do if you're a bystander at a roadside accident.
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"I'm not really one to ignore situations, so if there's a chance to help, I will. I think there are a lot of people who feel the same way, and certainly on that day, there were many people who were willing to step up and help."
Payinda says other witnesses helped with disabling a car engine that was redlining, looked for people who might've been thrown from the vehicle, consoled the injured and took care of children on the scene, and made sure the scene was safe so other cars wouldn't come barrelling in.
"It takes a village, and it was the best of New Zealand on that day. When you see responses like that, you realise there are many more good people in the world than what you might think if all you did was read the newspapers."
Taking a minute to assess an emergency situation will better serve those involved, Dr Gary Payinda says.
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What should you do if you're a bystander at an accident?
The first step, Payinda says, is to pause, take a breath, and assess the situation.
"Initially there's a lot more questions and anxiety than there are answers and calmness. Even a few seconds pause right at the beginning and a few deep breaths will help you get in the right frame of mind to help.
"You don't help the patient if you yourself become a casualty. You will be useless to them, and you'll actually compromise the patient's wellbeing if you become one of the injured."
Payinda says to ask yourself: What's the one thing I can do to help the situation?
"If the patient's bleeding heavily... I need to put pressure firmly and directly right on the wound and stop the bleeding.
"If they're an adult, unresponsive and not breathing properly... I need to start chest compressions which someone else is sent off to find a AED [defibrillator]."
"There's usually just one or two simple interventions we can do that really make a big difference. The other big thing is calling for help, you can delegate that task to another to call 111 and report back to you when help indeed is coming."
What if you're an outer bystander - not directly involved?
Even those on the sidelines play an important role, Payinda says.
"You have a little bit of ability to step back and ask, 'Is this scene safe, is anyone gonna get injured?' You have the ability to again, in a sort of more relaxed way, see what's going on and assess if we're dealing with the most important or life-threatening emergency right now."
By staying alert and offering assistance, Payinda says outer-circle bystanders can support those doing hands-on work.
"Sometimes it’s useful to be able to chime in and say, 'I notice there’s bleeding, do you want me to put some pressure on that? It looks like you’re getting tired from doing the chest compressions, do you want me to take over?'
"Being a helpful volunteer means being aware of what’s going on and seeing the big picture.”
What mistakes should you avoid?
One of the biggest misconceptions, Payinda says, is the fear of moving a patient.
“A common mistake that I see is when people are so scared to move a patient, often because they’re worried about a patient’s spine or back, they’re so afraid to move the patient that they allow them to come to harm in a way that could’ve been prevented.
“If you need to move the patient to keep them safe from further serious injury, or to manage an immediately life-threatening problem with their airway or breathing or circulation, then you should not hesitate to move the patient."
Another takeaway from his recent experience? Don’t get tunnel vision.
“One thing that’s always been reinforced in my training has been to always think about other victims, so not always being distracted by the most gruesome injury or the person who’s loudest at the scene. Sometimes you have to look for additional people who might be so badly injured that they can’t scream or shout for help.”
Be prepared
A few basic supplies in your car can make a big difference to your ability to help, Payinda says.
“Having a few disposable nitrile exam gloves, a pair of leather gloves, and a high viz vest are three things you can prepare to make it safer to fix your own car someday, and also to respond to a life-threatening emergency.
"People can see you and they know you aren’t one of the victims on the scene, that you’re someone there that might be able to help. Being a little bit prepared for these events will help them go a lot smoother.”
DRSABCD: A simple memory aid
The New Zealand Resuscitation Council suggests DRSABCD as a helpful memory aid for emergency care.
Dangers?, Responsive?, Send for help, Airway, Breathing?, start CPR, attach Defibrillator.
Payinda explains: "Assess for dangers to the patient, yourself, and bystanders, check if the patient is unresponsive, send for help (111 and AED), open the airway, assess breathing, if patient unresponsive and not breathing normally, start chest compressions (30 compressions then two breaths), as soon as an AED arrives, put it on the patient and follow its instructions."
